Bringing Sexy Back -- Study Looks At Sex And New Motherhood

One of the things you hear about sex after baby is that “you have to wait six weeks.”  A new study published online this month in the Journal Of Sexual Medicine, looked at when women resumed sex, what kind of sex they had and what motivated their timing.  It goes beyond the generic idea, and explores  why, when and how real new mothers have sex.  It found, (to no one’s surprise, I hope), that there are a lot of factors at play, and that it varies.

Before we get into it, though, can we just pause on the “Six Week Rule”?  Usually it’s expressed as something like:

You have to wait six weeks after having a baby before you resume normal relations.

Now, I ask you, what does any of that even mean?   Although we’ve all heard this “rule,” this is not some sort of medical canon.  In fact, as I understand it, there is no medical basis at all for a generic 6 week (or any!) proscription on sex.  Instead, this recommendation started with doctors giving their patients “permission” not to do it for a while out of some concern that the poor women otherwise couldn’t keep their husbands at bay.  

Can we look at all the assumptions there?  a. She has a husband.  b. He wants to have intercourse, obviously.  c. She doesn’t, obviously.  d. She can’t say no to him without a doctor’s note. e. The only kind of sex is intercourse.  f.  By six weeks she either should want to, or she should do it anyway, because for god’s sake we just gave her six weeks off, sheesh.

Doctors should not pretend there are medical reasons for things that have no medical reason.  

Also, what reason could there be?  No one ever spells it out.  There’s a kind of image that childbirth always causes a disfiguring gaping-wound trauma to your ladybits.  It is a Disaster Area that mysteriously requires no ongoing clinical care or medical attention, yet is so horrible that we cannot touch it, play with it, think of it or go there.  Vagina Zahadoom.

A normal spontaneous vaginal birth might leave you feeling sore and tender for a few days, but it’s not physical trauma that restricts your body’s normal functioning any more than some other kind of big workout.  Even for women who had stitches, the generic idea of avoiding all contact in the zone for six weeks is arbitrary (and tell me, how is an orgasm without penetration going to get anywhere near that scar?).  And what about the 33% of American moms who have a c-section?  What vaginal trauma do we think they suffered?  

I just hate the idea that we’re all carrying around this idea that birth is a vaginal explosion that turns your nether regions into Beirut.

So — if you want to have sex before you’re six weeks out, it is beyond unfortunate to be told a bullshit reason not to.  You’re a grown freaking woman; you’re allowed to have sex if you feel like it, it’s your body. Talk to your doctor and ask if there’s any reason *not* to.

And by the same token, if you don’t want to have sex, whether it’s been 3 weeks or 3 months or freaking five years, you don’t need a Fakey Mc-Fake medical excuse.  “I don’t feel like it now” is enough.  That’s the other thing about the Six Week Rule.  Do you know how many women I meet who feel unready for sexytimes after 5 weeks and six days?  Many.  Too often, I find, those moms  have interpreted the six-week thing as an affirmative injunction, like it’s mandatory to do it at six weeks, like by then they “ought to” want to “by now” because they had “six weeks off.”  Because their doctor said so.

No.  Your doctor has no idea what you like in bed, or when you like it, or how or where or why.  

(btw, I have never, in ten years of working with new moms, heard of a doctor who spontaneously had an actual conversation with a pregnant patient about this, asking what the couple’s sex life was like, and tailoring any future recommendation to their specific habits, desires and physical limitations, if any.)  

(btw2, What are “normal relations” anyway?  The Six Week Rule makes it seem like sex is just one thing — that everyone does it at the same time, the same way (and that “everybody” is a guy with a penis and a woman with a vagina and it’s all “insert tab a into slot b”).  Lots of folks dig intercourse, obvs, but it’s not the only way to get off.  Sex is supposed to be something that feels good, right?  And, as we grow, isn’t it normal that what feels good might also develop and change?)

** 

Soooo, this study looked at what actually happens with sex after a baby.  And one of the first things they found debunks the idea that no woman wants sex initially: 40% of women were masturbating in the first few weeks.  

Hm.

So, despite the “6 Week Rule” assumption that of course she doesn’t want it, apparently many women are at least into sex with themselves at first.

(you know what’s hard about blogging?  Everything I write I imagine how it could make someone feel bad.  So, I wrote that and now worry that someone reads it and feels guilty that she wasn’t getting herself off when her kid was 3 weeks old, like it’s one more thing on the endless perfectionist to-do list: have a perfect vag birth, breastfeed flawlessly, donate extra pumped milk to tsunami victims, lose all weight instantly, teach your child Mandarin and harp lessons while they are nursing, bake your own gluten free bread and do it all while masturbating!  So — NOT LIKE THAT.  Every one of us has to take some time to blend the newness of Being A Mother with the rest of who we were beforehand.  For many women, that means that the sexy stuff takes, temporarily, a back seat to the other projects.  For other women, though, being sexual never goes away, and that’s where that 40% figure becomes interesting.  My guess is that it has more to do with how she learns than with anything else — some women table everything else to immerse themselves in learning something new, others proceed more evenly.)

The study looked at what activities moms did and when they did it.  They also looked at the mom’s desire level. (I love that the study also separated out desire from what the ladies were doing and when they were doing it.  Because, as anyone who’s seen Girls, (or When Harry Met Sally) knows, it’s possible to engage in sexual activity without desire.  

They found that … it varies.  As to timing, “significant differences in time to resumption were found.”  They also found that not everyone was doing the same thing, duh!  Although a majority waited a couple months before intercourse, only 60% were having intercourse *at all* at 7 weeks.  Many women started with oral sex (giving) and masturbation before intercourse.

When identifying the factors at play in what activity women chose, and when, the study found the following factors were significant:

* good birth experience

* adequate social support

* mom felt the partner’s sexual fulfillment was important

* mom perceived partner had a lot of desire.  

* mom’s fatigue level

Results also suggested that postpartum desire was not  significantly influenced by breastfeeding status, vaginal issues, or psychosocial variables.  Desire was increased most when women had feelings of intimacy and closeness to their partners (shocker!).  Desire was lowered by fatigue, sleep issues and time constraints. 

One thing this study did not examine:  Was the sex any good?  Because isn’t that actually kind of the point?  I have a lot of clients and students whose main complaint about sex isn’t about what, when or how much, but that it’s lousy, dull, “different,” weird or even painful at first.  I’d love to see a study that examined sexual pleasure in new parents.  For now, if your baby is really young and you have resumed sex, it’s also not mandatory to do it a lot if it’s lousy.  For some folks, sex is not awesome the first few many times, for lots of reasons.  There are things that help.

So what does that add up to?   Women aren’t generic.  Some will feel more muted desire and need a sexual hiatus as they transition to motherhood, others are ready to go right away, but what “ready to go” means varies from mom to mom.  Some stuff is clear, though:  when we foster appropriate education and support (great childbirth class, labor support and appropriate clinical care to improve birth experience, postnatal support and a mom’s group to provide social support, cultural and societal supports that foster the bonding and intimacy between partners and help new parents get rest), we are investing in new parents’ partnerships, and in everyone’s well being.